Bone morphogenic protein-2 (BMP-2)-conjugated three-dimensional (3-D)-printed poly (L-lactic acid)(PLLA) scaffold is likely promising as an effective bone substitute for enhancing bone regeneration of massive bone defects caused by tumor resection, traumatic injury, or congenital diseases. The authors developed a new bone substitute using a novel strategy composed of 3-D-printed PLLA scaffolds through a sequential coating of catechol-conjugated alginate (C-AL), BMP-2, and collagen (CO). The 3-D-printed PLLA scaffold was successfully obtained with 5 mm of diameter, 1 mm of thickness, 400 lm of pore size, 187–230 lm of grid thickness, and 82% of porosity. Alkaline phosphatase (ALP) activity of the BMP-2-immobilized PLLA scaffold in MC3T3-E1 and W-20-17 cells was more increased than BMP-2 itself due to the controlled release of BMP-2 from the scaffold. Tenfold new bone formation for the BMP-2-immobilized PLLA scaffold was obtained by micro-CT analysis than PLLA scaffold without BMP-2 weeks after 4 weeks of transplantation model mouse. Further another big animal model study should be performed before clinical trials.

A 52-year-old man was referred to our hospital due to fever and myalgia that occurred 2 weeks earlier. He showed a complete atrioventricular block on his electrocardiogram, and his vital signs were unstable. On his transthoracic echocardiograph, the 1.5 cm vegetation in the aortic valve with severe aortic regurgitation suggested infective endocarditis. His transesophageal enchocardiograph showed abscess in his mitral-aortic intervalvular fibrosa and vegetation was suspected on his anterior mitral valve leaflet. The patient underwent an emergent operation for valve replacement with temporary epicardial pacing. Intraoperatively, the septal leaflet of his tricuspid valve was injured during the debridement of the abscess pocket that was extended to the membranous septum. The aortic, mitral, and tricuspid mechanical valves were replaced with annular reconstruction without complications. After 14 days of intravenous antibiotics, we successfully changed the epicardial pacemaker into a transvenous DDD-type permanent pacemaker by placing a left ventricular lead via the coronary sinus and an atrial lead in the right atrium appendage. The patient was discharged in a tolerable state and was examined uneventfully in our hospital's outpatient clinic for 8 months.
Abscess ; Ambulatory Care Facilities ; Anti-Bacterial Agents ; Aortic Valve ; Aortic Valve Insufficiency ; Atrioventricular Block* ; Coronary Sinus* ; Debridement ; Electrocardiography ; Endocarditis* ; Fever ; Heart Atria ; Heart Block ; Heart Valve Prosthesis ; Humans ; Middle Aged ; Mitral Valve ; Myalgia ; Pacemaker, Artificial ; Tricuspid Valve ; Vital Signs

Human palatine tonsil-derived mesenchymal stem cells (TMSCs) are known to be a new source of progenitor cells. Using waste tissue after tonsillectomy as a cell provider can be the biggest benefit of TMSCs, compared with other stem cells. The purpose of this study was to investigate tenogenic differentiation of TMSCs and to access the differential effects of transforming growth factor beta 3 (TGF-β3) on the tenogenesis of TMSCs. Human tonsil was obtained after tonsillectomy. Using a cytometric analysis, we were able to find that the TMSCs had typical mesenchymal stem cell markers: positive for CD73, CD90, and CD105, and negative for CD14, CD34, and CD45. Using TGF-β3, the expressions of tenocyte-specific genes and proteins, such as collagen type 1 (COL1), tenomodulin (TNMD), and scleraxis (SCX), were measured by a quantitative polymerase chain reaction (PCR), immunofluorescence staining, immunohistochemistry and Western blot analyses. Quantitative PCR assay showed that TGF-β3 significantly increased the expressions of tenocyte lineage marker genes, including COL1, TNMD, and SCX, at a 3-day treatment, compared with control. However, these increases were not found at long-term exposures (7 or 10 days), except that TNMD expression was maintained at 50 ng/mL at a 7-day exposure to TGF-β3. Like genes, the protein expression levels of COL1, TNMD, and SCX were also induced in TGF-β3-treated TMSCs in a 3-day treatment, which were maintained for 10 days, as evidenced by immunofluorescence staining, immunohistochemistry and Western blot analyses. This study demonstrated that TMSCs in tenogenic stimulation with TGF-β3 have a high tenogenic differentiation potential.
Blotting, Western ; Collagen ; Fluorescent Antibody Technique ; Humans ; Immunohistochemistry ; Mesenchymal Stromal Cells* ; Palatine Tonsil ; Polymerase Chain Reaction ; Stem Cells ; Tonsillectomy ; Transforming Growth Factor beta

Although DNA damage responses (DDRs) are reported to be involved in nitric oxide (NO) production in response to genotoxic stresses, the precise mechanism of DDR-mediated NO production has not been fully understood. Using a genotoxic agent aphidicolin, we investigated how DDRs regulate NO production in bovine aortic endothelial cells. Prolonged (over 24 h) treatment with aphidicolin increased NO production and endothelial NO synthase (eNOS) protein expression, which was accompanied by increased eNOS dimer/monomer ratio, tetrahydrobiopterin levels, and eNOS mRNA expression. A promoter assay using 5’-serially deleted eNOS promoters revealed that Tax-responsive element site, located at −962 to −873 of the eNOS promoter, was respon-sible for aphidicolin-stimulated eNOS gene expression. Aphidicolin increased CREB activity and ectopic expression of dominantnegative inhibitor of CREB, A-CREB, repressed the stimulatory effects of aphidicolin on eNOS gene expression and its promoter activity. Co-treatment with LY294002 decreased the aphidicolin-stimulated increase in p-CREB-Ser133 level, eNOS expression, and NO production. Furthermore, ectopic expression of dominant-negative Akt construct attenuated aphidicolin-stimulated NO production. Aphidicolin increased p-ATM-Ser1981 and the knockdown of ATM using siRNA attenuated all stimulatory effects of aphidicolin on p-Akt-Ser473 , p-CREB-Ser133 , eNOS expression, and NO production. Additionally, these stimulatory effects of aphidicolin were similarly observed in human umbilical vein endothelial cells. Lastly, aphidicolin increased acetylcholine-induced vessel relaxation in rat aortas, which was accompanied by increased p-ATM-Ser1981 , p-Akt-Ser473 , p-CREB-Ser 133 , and eNOS expression. In conclusion, our results demonstrate that in response to aphidicolin, activation of ATM/Akt/CREB/eNOS signaling cascade mediates increase of NO production and vessel relaxation in endothelial cells and rat aortas.

BACKGROUND: The number and proportion of live-alone elders in Korea have been increasing dramatically. We tried to identify the physical health status of live-alone elders in community and their needs for public health service in order to provide basic data for effective public health service to promote health and quality of life. METHODS: The subjects for this study were 38 nurses who provide visit-nursing service to live-alone elders in Seoul and Kyunggi Province. Data were collected by semi-structured questionnaires. RESULTS: The half of live-alone elders had disease, but only half of them took appropriate treatment. Barrier to treatment were difficulty to access to medical center, immobility, lack of drive and also poor insight. CONCLUSION: To solve the problems related to the elderly living alone in community, the instillation of public health policy that encompass professional medical service and comprehensive team approach are needed.
Aged ; Gyeonggi-do ; Humans ; Korea ; Public Health* ; Quality of Life ; Surveys and Questionnaires ; Seoul ; United States Public Health Service*

This study was to investigate the effects of individual and district-level socioeconomic status (SES) on the development of cognitive impairment among the elderly. A 3-year retrospective observational analysis (2010–2013) was conducted which included 136,217 community-dwelling healthy elderly who participated in the Seoul Dementia Management Project. Cognitive impairment was defined as 1.5 standard deviations below the norms on the Mini-mental status examination. In the individual lower SES group, the cumulative incidence rate (CIR) of cognitive impairment was 8.7% (95% confidence interval [CI], 8.64–8.70), whereas the CIR in the individual higher SES group was 4.1% (95% CI, 4.08–4.10). The CIR for lower district-level SES was 4.7% (95% CI, 4.52–4.86), while that in the higher district-level SES was 4.3% (95% CI, 4.06–4.44). There were no additive or synergistic effects between individual and district-level SES. From this study, the individual SES contributed 1.9 times greater to the development of cognitive impairment than the district-level SES, which suggests that individual SES disparities could be considered as one of the important factors in public health related to cognitive impairment in the elderly.
Aged* ; Cognition Disorders ; Dementia ; Humans ; Incidence ; Public Health ; Retrospective Studies ; Seoul* ; Social Class

BACKGROUND AND PURPOSE: Low-density lipoprotein (LDL) particle size is considered to be one of the more important cardiovascular risk factors, and small LDL particles are known to have atherogenic potential. The aim of this study was to determine whether LDL particle size is associated with stroke severity and functional outcome in patients with atherothrombotic stroke. METHODS: Between January 2009 and May 2011, 248 patients with first-episode cerebral infarction who were admitted to our hospital within 7 days after symptom onset were prospectively enrolled. LDL particle size was measured using the nondenaturing polyacrylamide gradient gel electrophoresis assay. Stroke severity was assessed by applying the National Institutes of Health Stroke Scale (NIHSS) at admission. Functional outcome was investigated at 3 months after the index stroke using the modified Rankin Scale (mRS), and poor functional outcome was defined as an mRS score of > or =3. RESULTS: The LDL particle size in the 248 patients was 25.9+/-0.9 nm (mean+/-SD). LDL particle size was inversely correlated with the degree of cerebral artery stenosis (p=0.010). Multinomial multivariate logistic analysis revealed that after adjustment for age, sex, and variables with p<0.1 in univariate analysis, LDL particle size was independently and inversely associated with stroke severity (NIHSS score > or =5; reference, NIHSS score 0-2; odds ratio=0.38, p=0.028) and poor functional outcome (odds ratio=0.44, p=0.038). CONCLUSIONS: The results of this study demonstrate that small LDL particles are independently correlated with stroke outcomes. LDL particle size is thus a potential biomarker for the prognosis of atherothrombotic stroke.
Atherosclerosis ; Cerebral Arteries ; Cerebral Infarction ; Constriction, Pathologic ; Electrophoresis ; Humans ; Lipoproteins ; National Institutes of Health (U.S.) ; Particle Size* ; Prognosis ; Prospective Studies ; Risk Factors ; Stroke*